Denture Wearer's Self Assessment of Vertical Dimension

Two groups of complete denture wearers were used. They were informed about normal facial proportions and were then asked to classify themselves into one of four face height classes. One group had to choose between four schematic drawings and the other between four color photos of a complete denture wearer, taken at different vertical dimensions. The patients' self-assessment was correlated to a professional assessment and measurements of the patients' face. The patients' assessments were significantly correlated to the professional assessment in both groups. Self assessment of facial proportions by complete denture wearers could be an easy and useful method of activating them to consult a dentist for check-up. The simple drawings were found to be most suitable.     

Reliability and comparison of two facial measurements to detect changes of occlusal vertical dimension in complete denture wearers

Gerodontology 2010; doi: 10.1111/j.1741‐2358.2009.00353.x
Reliability and comparison of two facial measurements to detect changes of occlusal vertical dimension in complete denture wearers Background: Facial measurements are frequently used to determine OVD. However, the reliability of neither the method nor the chosen landmarks has been cleared yet. Objective: This study compares the reliability of two facial measurements, subnasal (SN) to chin (C) and tip of the nose (TN) to C, for determining occlusal vertical dimension (OVD). Materials and methods: Thirty edentulous subjects with adequate neuromuscular co‐ordination, without signs and symptoms of temporomandibular disorders and who had been wearing complete dentures for at least 5 years were enrolled. A modified central bearing device was used to alter the OVD and facial measurements were made with a digital caliper. Student’s t‐test was used to compare the two measurements. Interobserver and intraobserver reliability were evaluated with Spearman’s rho correlation test. Results: TN–C distance had an improved correlation with the changes in intraoral alterations than SN–C distance. While the means of the changes in facial measurements were in good agreement with the intraoral alterations, the ranges were wide. Both interobserver and intraobserver reliability of the measurements were high. Conclusion: While facial measurement is not a good predictor of OVD, TN–C distance appears to be more reliable than SN–C distance.     

Maxillary complete denture movement during chewing in mandibular removable partial denture wearers

Objectives: To evaluate the pattern of maxillary complete denture movement during chewing for free‐end removable partial dentures (RPD) wearers, compared to maxillary and mandibular complete denture wearers. Materials and methods: Eighteen edentulous participants (group I) and 10 volunteers with bilateral posterior edentulous mandibles (group II) comprised the sample. Measures of mean denture movement and its variability were obtained by a kinesiographic instrument K6‐I Diagnostic System, during the mastication of bread and a polysulphide block. Data were analysed using two‐way anova (α = 0.05). Results: Upper movement during chewing was significantly lower for group II, regardless of the test food. The test food did not influence the vertical or lateral position of the denture bases, but more anterior dislocation was found when polysulphide blocks were chewed. Group II presented lower intra‐individual variability for the vertical axis. Vertical displacement was also more precise with bread as a test food. Conclusion: It can be concluded that mandibular free‐end RPD wearers show smaller and more precise movements than mandibular complete denture wearers.     

Factors affecting the distribution and prevalence of oral mucosal lesions in complete denture wearers

Gerodontology 2010; doi: 10.1111/j.1741‐2358.2009.00351.x
Factors affecting the distribution and prevalence of oral mucosal lesions in complete denture wearers Objective: To determine the frequency of the oral lesions related to gender, age, the length of time of denture usage, education level and economic status. Methods: The 153 patients with old complete dentures (CD) were asked to participate in the investigation. The subjects (76 male and 77 female) were 37–85 years of age with a mean age of 61.8 ± 9.8 years. Education, economic status and age factors were estimated in subgroups. The data obtained were evaluated by one‐way anova , Mann–Whitney U‐test, Kruskal–Wallis test, Student’s t‐test and chi‐squared test. The level of statistical significance was set at p < 0.05. Results: The patients who had denture stomatitis and traumatic ulcers were statistically significantly older than the ones who did not have these lesions (p < 0.05). Based on the length of denture usage, patients who had a flabby ridge, fibrous inflammatory hyperplasia, traumatic ulcers (p < 0.01) and denture stomatitis (p < 0.05) were using their dentures statistically significantly longer than the ones who had healthy tissues. Conclusions: The CD wearers should be advised to visit their dentist regularly to prevent oral mucosal lesions due to the changing supporting tissues during the length of denture usage and to improve their quality of life.     

Prevalence of temporomandibular disorders in a population of complete denture wearers

doi: 10.1111/j.1741‐2358.2011.00574.x
Prevalence of temporomandibular disorders in a population of complete denture wearers Background: Complete tooth loss among the elderly is still frequent in developing countries and the incidence of temporomandibular disorders (TMD) is a common finding in complete denture wearers. Objectives: The aim of this study was to evaluate the prevalence of temporomandibular disorders (TMD) in a population of complete denture wearers. Materials and Methods: The data were collected by four examiners for the diagnosis of use and need for complete dentures followed by the World Health Organization standards and interviews for TMD signs and symptoms evaluation. Exploratory variables included demographic, socio‐economic status and TMD prevalence. Results: The prevalence of TMD among denture wearers was 55.12%. Chi‐squared test showed no statistical difference between subjects with or without TMD for gender, geographical location and skin colour (p < 0.05). The number of subjects with TMD increased as the period of complete denture wear increased, although no statistical difference between groups were found (p < 0.05). Conclusions: There is a need of educational programmes aiming at the importance of health care and periodical change of a complete denture, and strategies with a preventive approach to quality general dental care.     

Cephalometric indicators of the vertical dimension of occlusion

The aim of this investigation was to establish precise indicators of the vertical dimension of occlusion (VDO) which could be used as objective parameters in prosthodontic treatment providing exact control of the reconstructed vertical dimension of occlusion, early detection of errors and correction of the vertical dimension of occlusion during complete denture manufacturing. A total of 60 lateral cephalometric radiographs of subjects with natural dentition and class I skeletal jaw relationship, of Serbian nationality from the region of Vojvodina, were included in the investigation. Thirty subjects were males, and thirty females, their age range was 20 to 29 years. Cephalometric analysis was performed by using "Dr. Ceph" computer software (FYI Technologies, GA, USA). By evaluation of the craniofacial complex in subjects with natural dentition, horizontal dentofacial developmental growth was established in the examined sample and it was based on the relationship between the posterior and anterior total facial height (S-Go:N-Me, female X=68.96%, male X=72.8%) and statistically significant differences were found between the sexes in almost all linear dimensions and in the relation between the posterior and the anterior total facial height. Highly significant differences (p<0.001) between the sexes were found in regard to anterior total facial height (N-Me, male X=120.75 mm, female X=112.72 mm) and the anterior lower facial height (ANS-Me, male X=67.87 mm, female X=61.50 mm) (p<0.05). The proportions of the upper and lower anterior facial heights (N-ANS:ANS-Me, male X=79.36%, female X=80.63%) were within normal values in both sexes. Facial harmony existed both in men and women. Cephalometric study of the subjects with complete natural dentition included in this study provided important and specific parameters for optimal reconstruction of vertical dimension of occlusion in the treatment of edentulous patients.     

Oral mucosal lesions in denture wearers

doi:10.1111/j.1741‐2358.2009.00289.x
Oral mucosal lesions in denture wearers Objective: To determine the prevalence of oral mucosal lesions (OMLs) and denture‐related mucosal lesions (DMLs) in denture wearers and to co‐relate the prevalence with age, gender, type of denture and any systemic conditions. Materials and methods: Dental records of 380 denture wearers were retrospectively reviewed for OMLs and DMLs. Results: We found 45% of the denture wearers had DMLs and 60.8% had OMLs not related to denture wearing. Although the prevalence of DMLs was higher in complete denture wearers than in partial denture wearers (49% vs. 42.2%), this difference was not significant. The most common DMLs were traumatic ulcer (19.5%) and denture‐induced stomatitis (18.1%). When analysed by type, traumatic ulcer, denture hyperplasia, frictional keratosis and candidiasis were more common in complete denture wearers, whereas denture‐induced stomatitis was more common in partial denture wearers. Frictional keratosis was more common in men than in women. The prevalence of OMLs not related to denture wearing was higher in complete denture wearers than in partial denture wearers, and the most common OML was fissured tongue (27.6%). No association between DMLs and systemic conditions or xerostomic drugs was noted. Conclusion: No differences in the prevalence of DMLs in association with denture type were found. The prevalence of OMLs not related to denture wearing was higher in complete denture wearers than in partial denture wearers. This difference was affected by age, and the data were similar to the findings observed in the elderly.     

Distribution and phospholipase activity of Candida species in different denture stomatitis types

The aim of this study was to evaluate the correlation between frequency and phospholipase activity of Candida species and denture stomatitis according to Newton’s classification. Seventy-five complete denture wearers were evaluated for the presence of yeasts on the palatal mucosa by culture method. In addition, the number of yeast isolates producing phospholipase and amount of this enzyme were determined using egg yolk agar plate method. According to Newton’s classification, 25 denture wearers were with healthy palatal mucosa while 50 were with any types of denture stomatitis. The frequency of yeasts was linked to whether subjects had Type II or Type III, but not Type I denture stomatitis. Candida albicans was the most frequently isolated species in denture wearers with and without clinical signs of denture stomatitis and it was the only species produced phospholipase. Although the amount of phospholipase produced by the C. albicans isolates from denture wearers in control and Type II and III DS groups was not significantly different, there was statistically significant difference in the number of C. albicans isolates producing phospholipase between patients with and without clinical signs of DS.     

Correlation between factors associated with the removable partial dentures use and Candida spp. in saliva

doi: 10.1111/j.1741‐2358.2010.00390.x
Correlation between factors associated with the removable partial dentures use and Candida spp. in saliva Objectives: To correlate the presence and number of Candida spp. in the saliva of wearers of removable partial dentures retained with precision attachments with the proportion of metal/acrylic resin present in the dentures. Methods: Saliva samples from 40 removable partial denture wearers (test) and one paired sample of individuals, non‐wearers of any type of removable denture (control) were collected, seeded, and the colony forming units of Candida counted and identified. The metal/acrylic resin proportion of each denture was quantified, using silicone plates pressed over each denture. Results: Candida spp. was found in the saliva of 80% of the individuals in the test group and 65% of the control, with C. albicans being the most prevalent species. The test group presented with the highest number of colony forming units of Candida per ml of saliva, and there was weak correlation between this number and the metal and resin area of the denture (Pearson’s coefficient of correlation). Greater prevalence and a higher number of colony forming units of Candida per ml of saliva occurred in removable partial denture wearers (p = 0.04) with a weak positive correlation between the metal and resin area and the number of colony forming units of Candida per ml of saliva. However, this correlation was more significant for the area of resin.     

The relationships between oral status, physical and mental health, nutritional status and diet type in elderly Japanese women with dementia

Objectives: To suggest methods for maintaining an adequate nutritional status for elderly patients with dementia by evaluating the relationships between oral status, physical and mental health, and feeding conditions. Background: Feeding difficulties in dementia patients are related to food intake, and failure to eat may be associated with weight loss in long‐term care facilities. The relationship between compromised oral function and diet is still unclear. Materials and methods: A cross‐sectional study of 94 elderly women with dementia (mean age 89.6 ± 5.6 years) from a nursing home was undertaken to investigate their oral, physical and mental and nutritional status. Results: There were significant differences in serum albumin (p = 0.0284), N‐ADL (p = 0.0005), NM scale (p = 0.0004) and HDS‐R (p = 0.0004) between denture wearers and non‐denture wearers. However, there were no significant differences in body mass index between denture wearers and non‐denture wearers. Conclusion: A suitable type of diet and assistance with feeding could maintain the nutritional status of elderly patients with dementia if they are still feeding themselves. The nutritional support team will benefit from the participation of a dentist.     

The oral health‐related quality of life in edentulous patients treated with Conventional complete dentures

Objective: To compare the oral health‐related quality of life (OHRQoL) between patients with both maxillary and mandibular complete denture and those with either the maxillary or the mandibular complete denture. Background: Satisfaction of denture wearers can be estimated using the OHRQoL questionnaires like the OHIP‐EDENT and the Geriatric Oral Health Assessment Index (GOHAI). Methods: Two questionnaires were used to compare the OHRQoL between edentulous patients who had conventional removable complete denture on both jaws and those who had on either one of the jaws. Result: The age of the participants ranged from 42 to 75 years, with the mean age of 58 ± 8.12 years. The mean OHIP‐EDENT scores were significantly high among those who wore conventional dentures in both jaws (54.12 ± 5.21), compared with the participants who only had denture either on upper or lower jaw (46.52 ± 7.35). It was noticed that the mean GOHAI score was significantly lower (p < 0.05) among participants who had conventional denture on both upper and lower jaw (28.25 ± 3.67), as compared to those who had conventional denture only on one arch (35.12 ± 2.11). Conclusion: Patients with complete dentures in both jaw (Group I) were less satisfied than patients with single complete denture (Group II). The result obtained in this study shows dissatisfaction with conventional dentures among edentulous patients.     

Radiographic evaluation of alveolar ridge heights of dentate and edentulous patients

doi: 10.1111/j.1741‐2358.2010.00391.x Radiographic evaluation of alveolar ridge heights of dentate and edentulous patients Objective: To evaluate the reduction of residual alveolar ridge height on panoramic radiographs and the differences between denture wearers and non‐denture wearers. Materials and methods: The study consisted of 147 individuals (74 men and 73 women) [50 were denture wearers and 50 non‐denture wearers (examination groups) and 47 of them were dentate (control group)]. Individuals having diseases impacting on bone were excluded. Vertical measurements were made at 15 sites (central incisors, first premolars and molars at the left and right of both jaws and the distance between the zygoma/orbit). MANOVA (multi‐variate analysis of variation) was used for the statistical analysis of the results. Results: There were significant differences between the alveolar ridge heights of dentate and edentulous groups (p < 0.001). Between the denture wearer and the non‐denture wearer groups, there was significant difference in the lower jaw (p < 0.001), but no significant difference in the upper jaw (p = 0.635). There were also differences between men and women (p < 0.005) and upper and lower jaws at every measurement sites (p < 0.01). Conclusion: Reduction in residual alveolar ridge height was in close relation with gender, denture usage and edentulousness.     

Elderly complete denture wearers: a social approach to tooth loss

doi: 10.1111/j.1741‐2358.2011.00550.x Elderly complete denture wearers: a social approach to tooth loss Objectives: To correlate emotional reactions to tooth loss with denture satisfaction attributes in elderly complete denture wearers. Background: Total tooth loss is a serious life event, and poor oral health has an impact on daily life. Edentulism treated by rehabilitation with dentures can have a positive effect on patients’ self‐image and social behaviour. Methods: A group of 80 edentulous subjects undergoing routine prosthetic care in a Greek Department of Prosthetic Dentistry were interviewed using two structured questionnaires. The first questionnaire explored reactions to tooth loss, whereas the second measured their subjective experience of complete dentures. The responses to both questionnaires were compared using the statistical package spss v.17. Results: The results showed significant correlation between aspects of tooth loss experience and complete denture satisfaction. Despite the fact that a substantial proportion of patients were satisfied with their complete dentures, some patients experienced increased social and psychological problems related to their edentulousness and the wearing of complete dentures. The aesthetic and functional aspects of complete dentures affected both patients’ social behaviour and self‐confidence. Conclusions: Total tooth loss was not only reflected in patient’s social behaviour and self‐image, but it had a complex and multifaceted impact on satisfaction from complete dentures.     

Denture contamination by yeasts in the elderly

Objectives: The aim of this study was to investigate yeast carriage in healthy denture wearers by swabbing and to evaluate the effect of denture hygiene habits. Materials and methods: Denture wearers (n = 87) without evidence of denture stomatitis or any other oral disease were investigated by separately swabbing the fitting surface of the upper denture and the corresponding palatal mucosa in contact with the appliance. In a group of volunteers, a gel without any active compound was spread on the palatal side of the denture once in every morning for 2 weeks. Results: Screening showed Candida colonisation of upper prosthesis in 75.9% of individuals. The most frequent species isolated were Candida albicans (77.9% of the positive cultures), Candida glabrata (44.1%) and Candida tropicalis (19.1%). Carriage of more than one yeast species was found in 48.5% of the contaminated dentures. There was a statistically significant association between denture contamination and palatal mucosa colonisation (chi‐squared test: p < 0.0001). Repeated swabbings after 1 week as well as during a weekly follow‐up for 1 month confirmed the denture contamination and its degree of severity. A daily gel application produced a yeast‐count decrease to 10% of the initial value after 2 weeks (chi‐squared test: p = 0.0134 and p = 0.2841 for prosthesis and palatal mucosa, respectively). Conclusion: This study documented the reliability of oral swabbing when investigating yeast carriage in healthy denture wearers. Moreover, just a diagnostic tool, sampling upper dentures for Candida could be the opportunity to verify the patient’s compliance to hygiene advice.     

Attitudes and usage of denture adhesives by complete denture wearers: a survey in Greece and the Netherlands

doi: 10.1111/j.1741‐2358.2011.00566.x
Attitudes and usage of denture adhesives by complete denture wearers: a survey in Greece and the Netherlands Objective: To explore whether there are differences in usage of and attitudes towards denture adhesives among patients in two countries. Background: There are no multi‐country surveys concerning usage of and attitudes towards denture adhesives from complete denture wearers. Materials and methods: The survey took place in Greece and the Netherlands with a sample of 284 and 165 consecutive complete denture wearers, respectively, by using a 9‐item prepared questionnaire. Statistical analysis relied on chi‐square test at α = 0.05. Results: In this survey, 26 and 20% of Greek and Dutch patients, respectively, had tried denture adhesive, but only 27% of them in Greece as well as in the Netherlands currently used it; 49% of the Greek and 45% of the Dutch participants rated the overall performance of adhesives as good. Between the two populations, no differences were identified in a majority of the research variables, except where 27% of Greeks answered that they did not know the existence of denture adhesives compared to none of the Dutch patients and when 90% of the Dutch contrary to 70% of Greeks reported that they did not need denture adhesives as they could manage their dentures well. Conclusion: The usage of and attitudes towards denture adhesives between the Greek and Dutch sample were similar with only two exceptions concerning the knowledge of existence and the need of using denture adhesives.     

Nocturnal masseter electromyographic activity of complete denture wearers

doi: 10.1111/j.1741‐2358.2011.00528.x Nocturnal masseter electromyographic activity of complete denture wearers Objective: Collection of normative data on activity patterns of the masseter during sleep in elderly denture wearers by portable electromyography (EMG) recorders. Background: Complete denture wearers might suffer from orofacial pain caused by myoarthropathies of the masticatory system. Indeed, denture instability may precipitate parafunctional habits and consequently muscle soreness and/or temporomandibular pain. Materials and methods: We collected normative masseter EMG data during sleep in 15 complete denture wearers (five women, 10 men, 56–88 years) by portable recorders in their natural environment. Activity periods (AP) were signal portions including subthreshold intervals ≤5 s. Signal amplitude was expressed in per cent of maximum voluntary contraction (%MVC). For this reason, maximum bite force was assessed. Twenty age‐matched dentate controls were also recorded for the maximum bite force. Results: We found 157.2 ± 86.5 AP per night, i.e. 24.0 ± 12.2 AP/h. Mean amplitude was 15.1 ± 4.3%MVC. AP lasted 6.8 ± 4.1 s, and their time integral was 126.3 ± 112.5%MVC?s. Maximum bite force was 116.8 ± 69.6 N in the edentulous, significantly lower than in controls (344.8 ± 150.4 N). Conclusions: Healthy complete denture wearers showed intermittent periods of nocturnal masseter activity of very low intensity and short duration.     

Examination of denture-cleaning methods based on the quantity of microorganisms adhering to a denture

doi: 10.1111/j.1741‐2358.2011.00461.x Examination of denture‐cleaning methods based on the quantity of microorganisms adhering to a denture Objectives: To investigate effective denture‐cleaning methods, we examined the relationships between the quantity of microorganisms adhering to dentures and the use of a denture brush and the frequency of use of a denture cleanser. Subjects and Methods: Denture plaque was collected from the mucosal surface of the examined dentures, which were 142 and 80 upper and lower complete dentures, respectively, worn by 96 outpatients (mean age: 71.9 years) of a university hospital and 41 nursing home residents (mean age: 84.8 years). The collected microorganisms were counted in terms of isolated representative colonies that were cultured and identified using standard methods. The use of a denture brush, the frequency of use, and the type and soaking time of denture cleansers as denture‐cleaning methods were surveyed. Results: The quantity of microorganisms was significantly lower in dentures of denture brush users than in those of non‐users in the outpatients (p < 0.01, Mann–Whitney U test). The quantity of microorganisms was significantly lower in the dentures of outpatients who used a denture cleanser daily or 3–4 times a week than in those who used one once or less per month and in the dentures of nursing home residents who used one daily than in those who used one at other frequencies (p < 0.05, Kruskal–Wallis test, followed by Dunn’s Multiple Comparison test). Conclusion: Within the limitations of this study, it was concluded that the use of a denture brush and daily use of denture cleanser should be recommended to complete dentures wearers as denture‐cleaning methods that effectively reduce the quantity of microorganisms adhering to dentures.     

Knowledge of prosthodontic treatment among denture-wearers and non-denture-wearers attending a dental institute in India: a survey report

Objective: Knowledge of subjects regarding prosthodontic treatment may play a role in their acceptance of the prostheses. The purpose of this survey was to assess the knowledge of prosthodontic treatment among the denture‐wearers and non‐denture‐wearers reporting to the Institute of Dental Sciences, Belgaum. Methods: A self‐designed closed‐ended questionnaire containing 14 questions was designed. Four‐hundred and nineteen subjects aged between 25 and 65 years were surveyed over a period of 2 months. Collected data were statistically analysed using chi‐squared test at a significance level of p < 0.05. Results: From the 419 subjects surveyed, 140 subjects (33.4%) were dentate and 279 subjects (66.6%) were edentulous either in the maxillary, mandibular or both arches. Among the 279 edentulous subjects, 143 (51.3%) did not use any kind of prosthesis. There was a statistically significant difference in knowledge regarding the replacement of teeth by artificial means, the number of visits required for the provision of a complete denture, problems with dentures among subjects using and not using them (p < 0.001) whereas no significant difference was found among the subjects regarding aesthetics with dentures and socializing with friends. Conclusion: Attempts should be made to raise the level of knowledge of both denture‐wearers and non‐denture‐wearers reporting to the Institute for any dental treatment.     

Complete denture hygiene and nocturnal wearing habits among patients attending the Prosthodontic Department in a Dental University in Brazil

Gerodontology 2010; doi: 10.1111/j.1741‐2358.2010.00369.x Complete denture hygiene and nocturnal wearing habits among patients attending the Prosthodontic Department in a Dental University in Brazil Objective: The aim of this study was to evaluate the overnight wearing and cleaning habits of complete denture wearers. Background: Successful complete denture treatment can be achieved when the patients are motivated and aware of appropriate denture wear and hygiene. Materials and methods: A sample of 224 complete denture wearers (162 women) aged 37–89 years was studied. Inclusion criteria comprised edentulous subjects who had received their new complete dentures between 2000 and 2005 in the Dental Clinic of the Araçatuba and Araraquara Dental School, São Paulo State University. Ethical approval was sought and granted. Subjects were interviewed using questions related to overnight denture wearing and denture cleaning habits. Possible statistical relationships among some of items were analysed by the chi‐square test at 5% significance level. Results: Of the patients, 55.8% removed their dentures during the overnight period and 88% did this every day. Among them, 66.4% removed both dentures. Most of the patients used brushing with toothpaste (105 patients – 46.87%) as a cleaning method. More than a half of the subjects (63.4%) showed biofilm and calculus on their dentures. Conclusion: The patients need instructions and motivation concerning denture hygienic and denture removal overnight.     

Oral health related quality of life of edentulous patients after denture relining with a silicone-based soft liner

doi: 10.1111/j.1741‐2358.2011.00503.x Oral health related quality of life of edentulous patients after denture relining with a silicone‐based soft liner Background: Knowledge of benefits caused by a treatment on quality of life is very relevant. Despite the wide use and acceptance of soft denture liners, it is necessary to evaluate the patient’s response about the use of these materials with regard to improvement in oral health related quality of life (OHRQoL). Objectives: The aim of this study was to evaluate the influence of denture relining in the OHRQoL of edentulous patients. Materials and methods: Thirty‐two complete denture wearers had their lower dentures relined with a silicone‐based material (Mucopren soft, Kettenbach, Germany) according to chairside procedures. OHRQoL was assessed before and after 3 months of relining by means of OHIP‐EDENT, and the median scores were compared by Wilcoxon test (p ≤ 0.05). Results: After 3 months of relining, participants reported significant improvement of their OHRQoL (p ≤ 0.01). Conclusion: Denture relining with a soft liner may have a positive impact on the perceived oral health of edentulous patients.